STD Awareness: Two Out of Three Ain’t Bad

For the past decade, human papillomavirus, better known as HPV, has been a pretty consistent headline grabber. Formerly a little-discussed virus, HPV was catapulted into the public consciousness in 2006, when suddenly people were all aflutter about this cancer-causing sexually transmitted pathogen, as well as Gardasil, the three-shot vaccination series the Centers for Disease Control and Prevention was recommending to preteen girls as protection from cervical cancer.

Kids 14 and younger develop such a strong immune response to Gardasil that they only need two doses — not three!

Dialogue has evolved since then, as people have recognized that HPV causes more than just cervical cancer — including anal cancer, head-and-neck cancer, and penile cancer — meaning that all children should be vaccinated, not just girls. And fears that the vaccine will “encourage” promiscuity still abound, despite thorough scientificdebunking. In fact, many experts believe that our skittishness surrounding sexuality — especially when it comes to teenagers — causes parents to turn a blind eye to the importance of vaccinating their children against HPV. (Unvaccinated children might not appreciate their parents’ choice, if, say, a few years down the line they find a smattering of genital warts below their belts.)

Ongoing scientific research into Gardasil and the virus it protects against provides continuous fodder for journalists covering medical and scientific advances. Here are just a few of the most recent headlines featuring HPV:

Women who were vaccinated as preteens could receive less frequent Pap tests — every five years for those who received the first-generation version of Gardasil, and every 10 years for those who received Gardasil 9.

Genetic analysis has found that HPV-16, the strain responsible for the majority of cervical and anal cancers, was given to our species by Neanderthals around 60,000 years ago. Thanks a lot, guys!

These headlines are fascinating, but probably some of the best news for the more practical-minded among us is that preteens’ immune response to the vaccine is so strong that they only need two shots of Gardasil — not three, as previously recommended. That extra dose meant an extra trip to the doctor — necessitating that parents take time off of work and kids endure yet one more sting of a needle. That obstacle had consequences: In 2015, among 14-year-olds, 49 percent of girls and 39 percent of boys had received at least two doses of Gardasil, while only 37 percent of girls and 28 percent of boys had received all three. Now that we know that kids 14 years old and younger can be protected by two doses, doctors expect to see a rise in coverage.

Two shots of Gardasil are now recommended for anyone from age 9 to 14. If someone waits until after turning 15 to receive the shot, they’ll need to get a third dose for full immune protection. Probably the most convenient time to receive the two Gardasil doses is when a child is 11 to 12 years old, and scheduled to receive meningitis and Tdap shots as well. It might be a drag to get three shots in one doctor’s visit, but my philosophy is that you’d might as well get them all over with! There aren’t too many people who hate needles more than I do, but I would never deny that the temporary pain of a shot is a small price to pay for avoiding deadly diseases down the line.

These new guidelines are based on research that has steadily been conducted and published in the decade since Gardasil’s debut, which has allowed scientists to refine and improve recommendations. Researchers have known for a while that, when it comes to the HPV vaccine, the immune response is stronger in younger people. For example, one study found that girls 9 to 13 years of age gain as much protection from two shots of Gardasil as young women ages 16 to 26 who received three shots.

But let’s say you didn’t receive Gardasil until after your 15th birthday, and you never finished the series. Two shots would still give you more protection than one shot or no shots. Some researchers think that the third shot might make someone’s immunity last longer, but that the first two shots provide many years of protection. How long this immunity lasts is still uncertain, but the above-linked study says “two doses are likely to protect vaccinees for more than a decade.” If you’re worried, you can talk to a doctor about receiving a third shot, because it might not be too late to give your immunity a boost.

To conclude, I hope most of us can agree that vaccines are pretty nifty: Injecting a few tiny particles stimulates your immune system to build antibodies, which can help destroy harmful pathogens. A well-oiled immune system can neutralize these invaders before they have a chance to make you sick! In the war against infectious disease, we should be boosting our immune systems at every opportunity, and vaccines are one of the best weapons in our arsenal. If you’d like more information about Gardasil, or would like to make an appointment to get vaccinated, you can call your local Planned Parenthood health center.

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About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.